Health Care Delivery System

901 WordsMar 20, 20104 Pages
In the past, managed care in the United States took the form of voluntary programs. Such programs date from about 1850, when managed care was provided chiefly by cooperative mutual benefit and fraternal beneficiary associations. Limited coverage by commercial companies was also introduced during that period, and subsequently many plans were established by industries and labor unions. Advocacy of government managed care in the United States began in the early 1900s. Theodore Roosevelt made national managed care one of the major planks of the Progressive party during the 1912 presidential campaign, and in 1915 a model bill for managed care was presented, but defeated, in numerous state legislatures. After 1920 opposition to…show more content…
Unlike insurers, HMOs provide care directly to patients; HMOs were viewed as low-cost alternatives to hospitals and private doctors. In 1997 approximately 651 HMOs provided care to 66.8 million people. In the 1980s and 90s political leaders again advanced a variety of national managed care proposals. There has been to date really limited empirical assessment of the impacts of these laws. One plan backed by leading Democrats was known as "pay or play" because it would have forced employers to provide managed care or pay into a national fund that would cover uninsured workers. A second, advanced by President G. H. W. Bush in 1992, would have provided tax breaks, vouchers, and other incentives to employers to extend managed care benefits. A third proposal, based on the Canadian model and nationalized health care, was opposed by most doctors and the insurance industry. In 1993, President Clinton, who had been elected on a promise of health-care reform, proposed a national managed care program that would have ultimately provided coverage for most citizens, but opposition by insurance, medical, small-business, and other groups killed it. In 1999, Clinton and Congress battled over developing a "patient's bill of rights," to protect people from denial of service and other HMO limitations. Many individual states have developed

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